School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom; Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom; Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
Reuben Sunil Kumar Sharma
Faculty of Veterinary Medicine, Universiti Putra Malaysia, Selangor, Malaysia
Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom; Lancaster University, Bailrigg, Lancaster, United Kingdom; Liverpool School of Tropical Medicine, Pembroke Place Liverpool, Liverpool, United Kingdom
School of Biosciences, Cardiff University, Cardiff, United Kingdom; Wildlife Health, Genetic and Forensic Laboratory, Sabah Wildlife Department, Wisma Muis, Kota Kinabalu, Malaysia; Danau Girang Field Centre, Sabah Wildlife Department, Kinabalu Sabah, Malaysia
Zarith Suraya Shahar
Faculty of Veterinary Medicine, Universiti Putra Malaysia, Selangor, Malaysia
Lee Col Lin
Faculty of Veterinary Medicine, Universiti Putra Malaysia, Selangor, Malaysia
Norhadila Zulkifli
Faculty of Veterinary Medicine, Universiti Putra Malaysia, Selangor, Malaysia
Nor Dilaila Mohd Saidi
Faculty of Veterinary Medicine, Universiti Putra Malaysia, Selangor, Malaysia
School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom; Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom; Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, United Kingdom; Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
Zoonotic disease dynamics in wildlife hosts are rarely quantified at macroecological scales due to the lack of systematic surveys. Non-human primates (NHPs) host Plasmodium knowlesi, a zoonotic malaria of public health concern and the main barrier to malaria elimination in Southeast Asia. Understanding of regional P. knowlesi infection dynamics in wildlife is limited. Here, we systematically assemble reports of NHP P. knowlesi and investigate geographic determinants of prevalence in reservoir species. Meta-analysis of 6322 NHPs from 148 sites reveals that prevalence is heterogeneous across Southeast Asia, with low overall prevalence and high estimates for Malaysian Borneo. We find that regions exhibiting higher prevalence in NHPs overlap with human infection hotspots. In wildlife and humans, parasite transmission is linked to land conversion and fragmentation. By assembling remote sensing data and fitting statistical models to prevalence at multiple spatial scales, we identify novel relationships between P. knowlesi in NHPs and forest fragmentation. This suggests that higher prevalence may be contingent on habitat complexity, which would begin to explain observed geographic variation in parasite burden. These findings address critical gaps in understanding regional P. knowlesi epidemiology and indicate that prevalence in simian reservoirs may be a key spatial driver of human spillover risk.